初治多发性骨髓瘤患者肿瘤细胞CD27表达与免疫状态和预后的相关性研究  

Correlation of CD27 Expression with Immune Status and Prognosis in Treatment⁃naive Patients with Multiple Myeloma

作　　者：任晓彤 郭欣雨 段沅伽 刘召云[1] 宋囡 邵宗鸿[1] 付蓉[1] 李丽娟[1] REN Xiao-tong;GUO Xin-yu;DUAN Yuan-jia;LIU Zhao-yun;SONG Nan;SHAO Zong-hong;FU Rong;LI Li-juan(Department of Hematology,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院血液科,天津300052

出　　处：《中国生物工程杂志》2023年第12期60-68,共9页China Biotechnology

摘　　要：目的:探讨CD27抗原在多发性骨髓瘤(multiple myeloma,MM)患者骨髓瘤细胞上的表达及其临床诊断价值,以及CD27表达水平不同的患者在细胞遗传学异常、免疫细胞分群等方面是否存在差异。方法:检测124名MM患者骨髓瘤细胞的免疫表型,分析异常浆细胞CD27表达水平,以及外周血T细胞亚群、B细胞亚群与Th1/Th2/Th17细胞亚群表达水平,并检测患者是否存在t(14;16)、p53缺失、del(13q14.3)、IGH重排、t(4;14)、t(11;14)、del(13q14)等细胞遗传学异常。搜集124名患者临床资料,比较CD27+MM患者与CD27-MM患者之间的各项常用临床指标有无明显差异。筛选在院经过4个疗程化疗的57名患者进行疗效评价,分析CD27+MM患者与CD27-MM患者疗效评价有无差别,并对在院内接受治疗的所有患者随访,进行生存分析。结果:124名MM患者中,异常浆细胞CD27阳性率为29.03%(36/124)。对124名MM患者的临床基线资料进行分析,发现CD27+MM与CD27-MM患者淋巴细胞数、血肌酐、乳酸脱氢酶(LDH)、β2-微球蛋白水平有统计学差异。同时,两组患者的细胞遗传学结果显示,CD27+MM患者的IGH重排发生率(31.58%)小于CD27-MM患者(53.41%)。CD27+MM患者的R-ISS分层较CD27-MM患者整体偏低。免疫细胞分群结果显示,CD27+MM患者淋巴细胞B亚群中的CD19+B细胞水平较CD27-MM患者低,而淋巴细胞Th1/Th2/Th17亚群中的TNF-α水平与T亚群中的CD3+CD4+水平较CD27-MM患者高。CD27+MM患者经过4个疗程化疗后,完全缓解+非常好的部分缓解(CR+VGPR)率较CD27-MM患者高,且整体无进展生存时间(PFS)较长。结论:MM患者异常浆细胞上CD27低表达可能与患者疾病进展及预后不良有关。Objective:To investigate the expression of CD27 antigen in myeloma cells of multiple myeloma(MM)patients and its clinical diagnostic value.An analysis of the correlation between CD27 expression and cytogenetic abnormality,as well as the immune cell population will be provided.Methods:Immunophenotypes of myeloma cells in 124 MM patients were detected to analyze the expression of CD27 on malignant plasma cells,and the expression of T subsets,B subsets and Th1/Th2/Th17 subsets in peripheral blood.The presence of cytogenetic abnormalities,such as t(14;16),p53 deletion,del(13q14.3),IGH rearrangement,t(4;14),t(11;14)and del(13q14)were analyzed.Clinical data of 124 patients were collected to compare whether there were significant differences between CD27+MM patients and CD27-MM patients.A total of 57 patients who underwent 4 courses of chemotherapy in our hospital were screened for efficacy evaluation,and to find the difference in efficacy evaluation between CD27+MM patients and CD27-MM patients.All patients who received treatment in our hospital were followed up for survival analysis.Results:The CD27+rate of abnormal plasma cells was 29.03%(36/124)in 124 MM patients.By analyzing the clinical baseline data of CD27+MM and CD27-MM patients,statistically significant differences were found in lymphocyte count,serum creatinine,lactate dehydrogenase,andβ2⁃microglobulin levels between two groups.Meanwhile,the cytogenetic and FISH results showed that the incidence of IGH rearrangement was lower in CD27+MM patients(31.58%)than in CD27-MM patients(53.41%).The R⁃ISS stratification in CD27+MM patients was lower than that in CD27-MM patients.The levels of CD19+B cells in CD27+MM patients were lower than those in CD27-MM patients,while the levels of TNF⁃αin Th1/Th2/Th17 subsets and the CD3+CD4+T cell subsets in CD27+MM patients were higher than those in CD27-MM patients.After 4 courses of chemotherapy,the CR+VGPR rate was higher in CD27+MM patients than in CD27-MM patients.Conclusions:The low expression of CD27 on malignant p

关 键 词：CD27抗原 多发性骨髓瘤 淋巴细胞亚群 

分 类 号：Q354[生物学—遗传学]